Zweegers Jeffrey, Otero Marisol E, van den Reek Juul M P A, van Lümig Paula P, Driessen Rieke J, Kievit Wietske, Seyger Marieke M B, van de Kerkhof Peter C M, de Jong Elke M G J
Department of Dermatology 370, Radboud University Medical Centre, René Descartesdreef 1, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
Acta Derm Venereol. 2016 May;96(4):453-8. doi: 10.2340/00015555-2276.
The efficacy of biologic or conventional systemic therapies for psoriasis has been shown in randomized controlled trials. Effectiveness, however, has been studied in daily practice cohorts, and no aggregation of effectiveness data is available. This systematic review searched PubMed and EMBASE and summarized the real-world evidence on effectiveness of biologics (adalimumab, etanercept, infliximab and ustekinumab) and conventional systemic therapies (acitretin, cyclosporine, fumarates and methotrexate) for the treatment of plaque psoriasis in adults. Thirty-two studies were included. Few data were available on infliximab, ustekinumab and conventional systemics. Results show that biologics and conventional systemics were effective in real-life treatment of psoriasis, with large ranges in the percentage of patients reaching 75% improvement in psoriasis area and severity index score compared with baseline, especially for etanercept and adalimumab treatment. Combination therapies of biologics with conventional systemics, and dose adjustments of biologics were frequently applied strategies and may explain the large range in improvements between cohorts.
生物制剂或传统全身疗法治疗银屑病的疗效已在随机对照试验中得到证实。然而，其有效性是在日常实践队列中进行研究的，目前尚无有效性数据的汇总。本系统评价检索了PubMed和EMBASE，并总结了关于生物制剂（阿达木单抗、依那西普、英夫利昔单抗和乌司奴单抗）和传统全身疗法（阿维A、环孢素、富马酸盐和甲氨蝶呤）治疗成人斑块状银屑病有效性的真实世界证据。共纳入32项研究。关于英夫利昔单抗、乌司奴单抗和传统全身疗法的数据较少。结果表明，生物制剂和传统全身疗法在银屑病的实际治疗中是有效的，与基线相比，达到银屑病面积和严重程度指数评分改善75%的患者百分比范围很大，尤其是依那西普和阿达木单抗治疗。生物制剂与传统全身疗法的联合治疗以及生物制剂的剂量调整是常用策略，这可能解释了不同队列之间改善情况的较大差异。
